Titulo:
Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup).
.
Sumario:
El pseudomixoma peritoneal (PMP) es una condición patológica pobremente entendida, caracterizada por la presencia de ascitis mucinosa relacionada a siembras peritoneales multifocales. Múltiples estudios histopatológicos que incluyeron inmunohistoquímica han sugerido que la mayoría de los PMP, si no todos los casos, derivan de adenomas mucinosos del apéndice más que de lesiones primarias del ovario. Pocos estudios que han evaluado la biología molecular y la genética del PMP se han reportado recientemente; sin embargo, estos trabajos solo han analizado un pequeño número de casos, incluyendo muestras heterogéneas de tumores mucinosos de comportamiento benigno y maligno, originados del apéndice y de los ovarios. Reportes previos han demostrado... Ver más
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Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup). Pathologic and molecular characteristics of pseudomyxoma peritonei (ONCOLGroup). El pseudomixoma peritoneal (PMP) es una condición patológica pobremente entendida, caracterizada por la presencia de ascitis mucinosa relacionada a siembras peritoneales multifocales. Múltiples estudios histopatológicos que incluyeron inmunohistoquímica han sugerido que la mayoría de los PMP, si no todos los casos, derivan de adenomas mucinosos del apéndice más que de lesiones primarias del ovario. Pocos estudios que han evaluado la biología molecular y la genética del PMP se han reportado recientemente; sin embargo, estos trabajos solo han analizado un pequeño número de casos, incluyendo muestras heterogéneas de tumores mucinosos de comportamiento benigno y maligno, originados del apéndice y de los ovarios. Reportes previos han demostrado mutaciones en el KRAS y pérdidas alélicas en los cromosomas 18q, 17p, 5q y 6q, en una cantidad de casos de PMP morfológicamente uniformes que presentan afectación sincrónica del ovario y del apéndice, así como en adenomas mucinosos apendiculares y en tumores ováricos productores de moco que tienen un bajo potencial de malignidad y que no están asociados al PMP. Nuestra revisión soporta ampliamente la conclusión de que los tumores mucinosos que involucran el apéndice y los ovarios en el PMP tienen como origen clonal un solo sitio, siendo el más probable el apéndice cecal. Pseudomyxoma peritonei (PMP) is a poorly understood condition characterized by mucinous ascites and multifocal peritoneal mucinous tumors. Several previous histopathological and immunohistochemical studies of PMP have suggested that most, if not all, cases of PMP are derived from mucinous adenomas of the appendix rather than from primary ovarian tumors. A few studies of the molecular genetics of PMP have been recently reported. However, these studies analyzed only a small number of cases and some included a heterogeneous group of mucinous tumors, including both benign and malignant appendiceal and ovarian neoplasms. Previous reports demonstrated K-ras mutations and allelic losses of chromosomes 18q, 17p, 5q, and 6q in a substantial number of morphologically uniform cases of PMP with synchronous ovarian and appendiceal tumors as well as in appendiceal mucinous adenomas and ovarian mucinous tumors of low malignant potential unassociated with PMP. Our review strongly support the conclusion that mucinous tumors involving the appendix and ovaries in PMP are clonal and derived from a single site, most likely the appendix. Otero, Jorge Miguel Arias, Fernando Londoño, Eduardo Quintero, Paula Carranza, Hernán Vargas, Carlos Serrano, Silvia Torres, Diana Carvajalino, Sabrina Becerra, Henry Rojas, Leonardo Rodríguez, Carlos Iván Granados, John Jairo Reveiz, Ludovic Rodríguez, Juli Katherine Cardona, Andrés Felipe molecular genética apéndice ovario pseudomixoma peritoneal molecular genetics appendix ovary pseudomixoma peritonei 1 1 Núm. 1 , Año 2012 : Abril Artículo de revista Journal article 2012-04-01T00:00:00Z 2012-04-01T00:00:00Z 2012-04-01 application/pdf Asociación Colombiana de Hematología y Oncología (ACHO) Revista Colombiana de Hematología y Oncología 2256-2877 2256-2915 https://revista.acho.info/index.php/acho/article/view/288 10.51643/22562915.288 https://doi.org/10.51643/22562915.288 spa https://creativecommons.org/licenses/by-nc-sa/4.0 Jorge Miguel Otero - 2012 Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0. 52 59 Werth R. Klinische und anatomische Untersuchungen zur Lehre von den bauchgeschwullsten und der laparotomie. Arch Gynecol Obstet. 1884;24:100-18. Galani E, Marx GM, Steer CB, Culora G, Harper PG. Pseudomyxoma peritonei: the ‘controversial’ disease. Int J Gynecol Cancer. 2003;13(4):413-8. Sugarbaker PH. New standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome? Lancet Oncol. 2006;7(1):69-76. Ronnett BM, Zahn CM, Kurman RJ, Kass ME, Sugarbaker PH, Shmookler BM. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol. 1995;19(12):1390- 408. Sherer DM, Abulafia O, Eliakim R. Pseudomyxoma peritonei. a review of current literature. Gynecol Obstet Invest. 2001;51(2):73-80. Lo NS, Sarr MG. Mucinous cystadenocarcinoma of the appendix. The controversy persists: a review. Hepatogastroenterology. 2003;50(50):432-7. Sugarbaker PH. Cytoreductive surgery and peri-operative intraperitoneal chemotherapy as a curative approach to pseudomyxoma peritonei syndrome. Eur J Surg Oncol. 2001;27(3):239-43. Bryant AJ, Clegg M, Sidhu K, Brodin H, Royle P, Davidson P. Systematic review of the Sugarbaker procedure for pseudomyxoma peritonei. Br J Surg. 2005;92(2):153-8. National Institute for Clinical Excellence (NICE). Complete cytoreduction for pseudomyxoma peritonei (Sugarbaker technique). Disponible en: (consulta del 15 de enero de 2010). Sugarbaker PH. The natural history, gross pathology, and histopathology of appendiceal epithelial neoplasms. Eur J Surg Oncol. 2006;32(6):644-7. Woodruff R, McDonald JR. Benign and malignant cystic tumors of the appendix. Surg Gynecol Obstet. 1940;71:750-5. Carr NJ, McCarthy WF, Sobin LH. Epithelial noncarcinoid tumors and tumor-like lesions of the appendix. A clinicopathologic study of 184 patients with a multivariate analysis of prognostic factors. Cancer. 1995;75(3):757–768. Pai RK, Longacre TA. Appendiceal mucinous tumors and pseudomyxoma peritonei: histologic features, diagnostic problems, and proposed classification. Adv Anat Pathol. 2005;12(6):291– 311. Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH. Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. Am J Surg Pathol. 2003;27(8):1089-103. Misdraji J. Appendiceal mucinous neoplasms. controversial issues. Arch Pathol Lab Med. 2010;134(6):864-70. Ronnett BM, Shmookler BM, Sugarbaker PH, Kurman RJ. Pseudomyxoma peritonei: new concepts in diagnosis, origin, nomenclature, and relationship to mucinous borderline (low malignant potential) tumors of the ovary. Anat Pathol. 1997;2:197-226. Baratti D, Kusamura S, Nonaka D, Cabras AD, Laterza B, Deraco M. Pseudomixoma peritonei: biological features are the dominant prognostic determinants after complete cytoreduction and hyperthermic intraperitoneal chemotherapy. Ann Surg. 2009;249(2):243-9. Ferreira CR, Carvalho JP, Soares FA, Siqueira SA, Carvalho FM. Mucinous ovarian tumors associated with pseudomyxoma peritonei of adenomucinosis type: immunohistochemical evidence that they are secondary tumors. Int J Gynecol Cancer. 2008;18(1):59-65. Nonaka D, Kusamura S, Baratti D, Casali P, Younan R, Deraco M. CDX-2 expression in pseudomixoma peritonei: a clinicopathological study of 42 cases. Histopathology. 2006;49(4):381-7. Mall AS, Chirwa N, Govender D, Lotz Z, Tyler M, Rodrigues J, et al. MUC2, MUC5AC and MUC5B in the mucus of a patient with pseudomyxoma peritonei: biochemical and immunohistochemical study. Pathol Int. 2007;57(8):537-47. O’Connell JT, Tomlinson JS, Roberts AA, McGonigle KF, Barsky SH. Pseudomyxoma peritonei is a disease of MUC2-expressing goblet cells. Am J Pathol. 2002;161(2):551-64. Teixeira MR, Qvist H, Giercksky KE, Bøhler PJ, Heim S. Cytogenetic analysis of several pseudomyxoma peritonei lesions originating from a mucinous cystadenoma of the appendix. Cancer Genet Cytogenet. 1997;93(2):157-9. Shih IM, Yan H, Speyrer D, Shmookler BM, Sugarbaker PH, Ronnett BM. Molecular genetic analysis of appendiceal mucinous adenomas in identical twins, including one with pseudomyxoma peritonei. Am J Surg Pathol. 2001;25(8):1095-9. Chuaqui RF, Zhuang Z, Emmert-Buck MR, Bryant BR, Nogales F, Tavassoli FA, et al. Genetic analysis of synchronous mucinous tumors of the ovary and appendix. Hum Pathol. 1996;27(2):165- 71. Feltmate CM, Lee KR, Johnson M, Schorge JO, Wong KK, Hao K, et al. Whole-genome allelotyping identified distinct loss-ofheterozygosity patterns in mucinous ovarian and appendiceal carcinomas. Clin Cancer Res. 2005;11(21):7651-7. Szych C, Staebler A, Connolly DC, Wu R, Cho KR, Ronnett BM. Molecular genetic evidence supporting the clonality and appendiceal origin of pseudomyxoma peritonei in women. Am J Pathol. 1999;154(6):1849-55. O’Connell JT, Hacker CM, Barsky SH. MUC2 is a molecular marker for pseudomyxoma peritonei.Mod Pathol. 2002;15(9):958-72. Ye Y, Nawaz Z, Loggie BW. Small interfering RNA (siRNA) directed against MUC2 mucin inhibits tumor growth in nude mice xenograft model of human colon cancer. ASCO GI 2006 (abstract 308). Loggie B, Silva E, Nawaz Z, Gatalica Z, Ella G. Inhibition of Mucin2 production: implications for treatment of pseudomyxoma peritonei. ASCO GI 2004 (abstract 200). Bu X, Li N, Tian X, Huang P. Gamma-secretase inhibitor, a potential target therapy for MUC2-positive colorectal carcinoma. Neoplasma. 2011;58(4):343-7. Chang MS, Byeon SJ, Yoon SO, Kim BH, Lee HS, Kang GH, et al. Leptin, MUC2 and mTOR in appendiceal mucinous neoplasms. Pathobiology. 2012;79(1):45-53. Heiskala K, Giles-Komar J, Heiskala M, Andersson LC. High expression of RELP (Reg IV) in neoplastic goblet cells of appendiceal mucinous cystadenoma and pseudomyxoma peritoneo. Virchows Arch. 2006;448(3):295-300. https://revista.acho.info/index.php/acho/article/download/288/258 info:eu-repo/semantics/article http://purl.org/coar/resource_type/c_6501 http://purl.org/redcol/resource_type/ARTREF info:eu-repo/semantics/publishedVersion http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 Text Publication |
| institution |
ASOCIACION COLOMBIANA DE HEMATOLOGIA Y ONCOLOGIA |
| thumbnail |
https://nuevo.metarevistas.org/ASOCIACIONCOLOMBIANADEHEMATOLOGIAYONCOLOGIA/logo.png |
| country_str |
Colombia |
| collection |
Revista Colombiana de Hematología y Oncología |
| title |
Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup). |
| spellingShingle |
Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup). Otero, Jorge Miguel Arias, Fernando Londoño, Eduardo Quintero, Paula Carranza, Hernán Vargas, Carlos Serrano, Silvia Torres, Diana Carvajalino, Sabrina Becerra, Henry Rojas, Leonardo Rodríguez, Carlos Iván Granados, John Jairo Reveiz, Ludovic Rodríguez, Juli Katherine Cardona, Andrés Felipe molecular genética apéndice ovario pseudomixoma peritoneal molecular genetics appendix ovary pseudomixoma peritonei |
| title_short |
Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup). |
| title_full |
Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup). |
| title_fullStr |
Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup). |
| title_full_unstemmed |
Características patológicas y moleculares del pseudomixoma peritoneal (ONCOLGroup). |
| title_sort |
características patológicas y moleculares del pseudomixoma peritoneal (oncolgroup). |
| title_eng |
Pathologic and molecular characteristics of pseudomyxoma peritonei (ONCOLGroup). |
| description |
El pseudomixoma peritoneal (PMP) es una condición patológica pobremente entendida, caracterizada por la presencia de ascitis mucinosa relacionada a siembras peritoneales multifocales. Múltiples estudios histopatológicos que incluyeron inmunohistoquímica han sugerido que la mayoría de los PMP, si no todos los casos, derivan de adenomas mucinosos del apéndice más que de lesiones primarias del ovario. Pocos estudios que han evaluado la biología molecular y la genética del PMP se han reportado recientemente; sin embargo, estos trabajos solo han analizado un pequeño número de casos, incluyendo muestras heterogéneas de tumores mucinosos de comportamiento benigno y maligno, originados del apéndice y de los ovarios. Reportes previos han demostrado mutaciones en el KRAS y pérdidas alélicas en los cromosomas 18q, 17p, 5q y 6q, en una cantidad de casos de PMP morfológicamente uniformes que presentan afectación sincrónica del ovario y del apéndice, así como en adenomas mucinosos apendiculares y en tumores ováricos productores de moco que tienen un bajo potencial de malignidad y que no están asociados al PMP. Nuestra revisión soporta ampliamente la conclusión de que los tumores mucinosos que involucran el apéndice y los ovarios en el PMP tienen como origen clonal un solo sitio, siendo el más probable el apéndice cecal.
|
| description_eng |
Pseudomyxoma peritonei (PMP) is a poorly understood condition characterized by mucinous ascites and multifocal peritoneal mucinous tumors. Several previous histopathological and immunohistochemical studies of PMP have suggested that most, if not all, cases of PMP are derived from mucinous adenomas of the appendix rather than from primary ovarian tumors. A few studies of the molecular genetics of PMP have been recently reported. However, these studies analyzed only a small number of cases and some included a heterogeneous group of mucinous tumors, including both benign and malignant appendiceal and ovarian neoplasms. Previous reports demonstrated K-ras mutations and allelic losses of chromosomes 18q, 17p, 5q, and 6q in a substantial number of morphologically uniform cases of PMP with synchronous ovarian and appendiceal tumors as well as in appendiceal mucinous adenomas and ovarian mucinous tumors of low malignant potential unassociated with PMP. Our review strongly support the conclusion that mucinous tumors involving the appendix and ovaries in PMP are clonal and derived from a single site, most likely the appendix.
|
| author |
Otero, Jorge Miguel Arias, Fernando Londoño, Eduardo Quintero, Paula Carranza, Hernán Vargas, Carlos Serrano, Silvia Torres, Diana Carvajalino, Sabrina Becerra, Henry Rojas, Leonardo Rodríguez, Carlos Iván Granados, John Jairo Reveiz, Ludovic Rodríguez, Juli Katherine Cardona, Andrés Felipe |
| author_facet |
Otero, Jorge Miguel Arias, Fernando Londoño, Eduardo Quintero, Paula Carranza, Hernán Vargas, Carlos Serrano, Silvia Torres, Diana Carvajalino, Sabrina Becerra, Henry Rojas, Leonardo Rodríguez, Carlos Iván Granados, John Jairo Reveiz, Ludovic Rodríguez, Juli Katherine Cardona, Andrés Felipe |
| topicspa_str_mv |
molecular genética apéndice ovario pseudomixoma peritoneal |
| topic |
molecular genética apéndice ovario pseudomixoma peritoneal molecular genetics appendix ovary pseudomixoma peritonei |
| topic_facet |
molecular genética apéndice ovario pseudomixoma peritoneal molecular genetics appendix ovary pseudomixoma peritonei |
| citationvolume |
1 |
| citationissue |
1 |
| citationedition |
Núm. 1 , Año 2012 : Abril |
| publisher |
Asociación Colombiana de Hematología y Oncología (ACHO) |
| ispartofjournal |
Revista Colombiana de Hematología y Oncología |
| source |
https://revista.acho.info/index.php/acho/article/view/288 |
| language |
spa |
| format |
Article |
| rights |
https://creativecommons.org/licenses/by-nc-sa/4.0 Jorge Miguel Otero - 2012 Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0. info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 |
| references |
Werth R. Klinische und anatomische Untersuchungen zur Lehre von den bauchgeschwullsten und der laparotomie. Arch Gynecol Obstet. 1884;24:100-18. Galani E, Marx GM, Steer CB, Culora G, Harper PG. Pseudomyxoma peritonei: the ‘controversial’ disease. Int J Gynecol Cancer. 2003;13(4):413-8. Sugarbaker PH. New standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome? Lancet Oncol. 2006;7(1):69-76. Ronnett BM, Zahn CM, Kurman RJ, Kass ME, Sugarbaker PH, Shmookler BM. Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis. A clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei”. Am J Surg Pathol. 1995;19(12):1390- 408. Sherer DM, Abulafia O, Eliakim R. Pseudomyxoma peritonei. a review of current literature. Gynecol Obstet Invest. 2001;51(2):73-80. Lo NS, Sarr MG. Mucinous cystadenocarcinoma of the appendix. The controversy persists: a review. Hepatogastroenterology. 2003;50(50):432-7. Sugarbaker PH. Cytoreductive surgery and peri-operative intraperitoneal chemotherapy as a curative approach to pseudomyxoma peritonei syndrome. Eur J Surg Oncol. 2001;27(3):239-43. Bryant AJ, Clegg M, Sidhu K, Brodin H, Royle P, Davidson P. Systematic review of the Sugarbaker procedure for pseudomyxoma peritonei. Br J Surg. 2005;92(2):153-8. National Institute for Clinical Excellence (NICE). Complete cytoreduction for pseudomyxoma peritonei (Sugarbaker technique). Disponible en: (consulta del 15 de enero de 2010). Sugarbaker PH. The natural history, gross pathology, and histopathology of appendiceal epithelial neoplasms. Eur J Surg Oncol. 2006;32(6):644-7. Woodruff R, McDonald JR. Benign and malignant cystic tumors of the appendix. Surg Gynecol Obstet. 1940;71:750-5. Carr NJ, McCarthy WF, Sobin LH. Epithelial noncarcinoid tumors and tumor-like lesions of the appendix. A clinicopathologic study of 184 patients with a multivariate analysis of prognostic factors. Cancer. 1995;75(3):757–768. Pai RK, Longacre TA. Appendiceal mucinous tumors and pseudomyxoma peritonei: histologic features, diagnostic problems, and proposed classification. Adv Anat Pathol. 2005;12(6):291– 311. Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH. Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases. Am J Surg Pathol. 2003;27(8):1089-103. Misdraji J. Appendiceal mucinous neoplasms. controversial issues. Arch Pathol Lab Med. 2010;134(6):864-70. Ronnett BM, Shmookler BM, Sugarbaker PH, Kurman RJ. Pseudomyxoma peritonei: new concepts in diagnosis, origin, nomenclature, and relationship to mucinous borderline (low malignant potential) tumors of the ovary. Anat Pathol. 1997;2:197-226. Baratti D, Kusamura S, Nonaka D, Cabras AD, Laterza B, Deraco M. Pseudomixoma peritonei: biological features are the dominant prognostic determinants after complete cytoreduction and hyperthermic intraperitoneal chemotherapy. Ann Surg. 2009;249(2):243-9. Ferreira CR, Carvalho JP, Soares FA, Siqueira SA, Carvalho FM. Mucinous ovarian tumors associated with pseudomyxoma peritonei of adenomucinosis type: immunohistochemical evidence that they are secondary tumors. Int J Gynecol Cancer. 2008;18(1):59-65. Nonaka D, Kusamura S, Baratti D, Casali P, Younan R, Deraco M. CDX-2 expression in pseudomixoma peritonei: a clinicopathological study of 42 cases. Histopathology. 2006;49(4):381-7. Mall AS, Chirwa N, Govender D, Lotz Z, Tyler M, Rodrigues J, et al. MUC2, MUC5AC and MUC5B in the mucus of a patient with pseudomyxoma peritonei: biochemical and immunohistochemical study. Pathol Int. 2007;57(8):537-47. O’Connell JT, Tomlinson JS, Roberts AA, McGonigle KF, Barsky SH. Pseudomyxoma peritonei is a disease of MUC2-expressing goblet cells. Am J Pathol. 2002;161(2):551-64. Teixeira MR, Qvist H, Giercksky KE, Bøhler PJ, Heim S. Cytogenetic analysis of several pseudomyxoma peritonei lesions originating from a mucinous cystadenoma of the appendix. Cancer Genet Cytogenet. 1997;93(2):157-9. Shih IM, Yan H, Speyrer D, Shmookler BM, Sugarbaker PH, Ronnett BM. Molecular genetic analysis of appendiceal mucinous adenomas in identical twins, including one with pseudomyxoma peritonei. Am J Surg Pathol. 2001;25(8):1095-9. Chuaqui RF, Zhuang Z, Emmert-Buck MR, Bryant BR, Nogales F, Tavassoli FA, et al. Genetic analysis of synchronous mucinous tumors of the ovary and appendix. Hum Pathol. 1996;27(2):165- 71. Feltmate CM, Lee KR, Johnson M, Schorge JO, Wong KK, Hao K, et al. Whole-genome allelotyping identified distinct loss-ofheterozygosity patterns in mucinous ovarian and appendiceal carcinomas. Clin Cancer Res. 2005;11(21):7651-7. Szych C, Staebler A, Connolly DC, Wu R, Cho KR, Ronnett BM. Molecular genetic evidence supporting the clonality and appendiceal origin of pseudomyxoma peritonei in women. Am J Pathol. 1999;154(6):1849-55. O’Connell JT, Hacker CM, Barsky SH. MUC2 is a molecular marker for pseudomyxoma peritonei.Mod Pathol. 2002;15(9):958-72. Ye Y, Nawaz Z, Loggie BW. Small interfering RNA (siRNA) directed against MUC2 mucin inhibits tumor growth in nude mice xenograft model of human colon cancer. ASCO GI 2006 (abstract 308). Loggie B, Silva E, Nawaz Z, Gatalica Z, Ella G. Inhibition of Mucin2 production: implications for treatment of pseudomyxoma peritonei. ASCO GI 2004 (abstract 200). Bu X, Li N, Tian X, Huang P. Gamma-secretase inhibitor, a potential target therapy for MUC2-positive colorectal carcinoma. Neoplasma. 2011;58(4):343-7. Chang MS, Byeon SJ, Yoon SO, Kim BH, Lee HS, Kang GH, et al. Leptin, MUC2 and mTOR in appendiceal mucinous neoplasms. Pathobiology. 2012;79(1):45-53. Heiskala K, Giles-Komar J, Heiskala M, Andersson LC. High expression of RELP (Reg IV) in neoplastic goblet cells of appendiceal mucinous cystadenoma and pseudomyxoma peritoneo. Virchows Arch. 2006;448(3):295-300. |
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